Pubertal Stage-Dependent Anthropometric Variations in Turkish Children with Adolescent Idiopathic Scoliosis: An In-Depth Analysis.

BACKGROUND Identifying predictive factors for anthropometric changes during puberty in adolescent idiopathic scoliosis (AIS) is critical for prognosis and management. This study aimed to discern these factors in the Turkish AIS population, by analyzing variations against female breast development stages and male testicular volume, benchmarked against national standards. MATERIAL AND METHODS A cross-sectional study was conducted between 2018 and 2022, involving children aged 10 to 18 years from the Orthopedics and Pediatrics Clinics. AIS patients and controls were assessed concerning pubertal status (Tanner stage), chronological age, skeletal maturation (Tanner-Whitehouse), and anthropometric parameters (height, weight, and body mass index). RESULTS AIS patients were compared to controls, stratified by pubertal stages. In girls across all stages, significant differences emerged in bone age, BMI, and weight between AIS and controls (p<0.01). In boys, AIS patients significantly differed in bone age from controls across all stages (p<0.001). At stage V, controls demonstrated higher BMI than AIS boys (p<0.001), while at stage I, AIS boys had significantly higher height and weight compared to controls (p<0.001). CONCLUSIONS AIS patients demonstrate distinctive pubertal growth abnormalities, with males and females presenting divergent patterns. Understanding these variations could inform better management of AIS during the critical pubertal growth period.

Association Among Complete Blood Count Parameters, Bone Mineral Density, and Cobb Angle in Cases of Adolescent Idiopathic Scoliosis.

BACKGROUND Improving the quality of life of scoliosis patients with appropriate preventive measures is critical. This study aimed to investigate the relationships among bone mass, Cobb angle, and complete blood count (CBC) parameters in patients with scoliosis. MATERIAL AND METHODS This joint study was conducted by the pediatric department and orthopedics clinics, which used the medical records of patients aged 10-18 years between 2018 and 2022. Patients were divided into 3 groups according to the Cobb angle. Patient blood count levels from medical records and bone mineral density (BMD) Z scores (g/cm²) were compared among groups. Notably, BMD Z scores were calculated using a (BMD) dataset from local Turkish children after adjusting for height and age. RESULTS A total of 184 individuals (120 females, 64 males) were included in the study. There were statistically significant differences among the groups in platelet-to-lymphocyte ratio (PLR). Significant differences in DXA Z scores among groups were found. There was a significantly strong and positive correlation between DXA Z scores and all CBC parameters in patients with severe scoliosis. CONCLUSIONS This study found that CBC parameters can predict BMD in adolescents. Furthermore, the association between vitamin D deficiency and low BMD may contribute to the follow-up of body adaptation in patients with scoliosis receiving conservative treatment.

Ceramic femoral head in highly cross-linked polyethylene cup. 5 year results of a randomized trial.

BACKGROUND: Although few methods are used to estimate polyethylene liner wear from radiographs of total hip replacements, there is no consensus with regard to the accuracy of these methods. Highly cross-linked polyethylene (XLPE) is reported to have low rates of linear wear in the literature. However, there are not reports about wear rate of ceramic head in hxple cup at 5 years postoperatively, evaluated by Dorr method. We evaluated the wear rate of HXPLE, within the first five years after implantation using manual techniques of Dorr. MATERIAL AND METHODS: We evaluated 143 patients (93 males and 50 females) with one design of uncemented acetabular component, a 40-mm (77 hips) or 44-mm (66 hips) ceramic femoral head and the annealed highly cross-linked crossfire polyethylene (X3) insert used in combination with Secur-Fit Advanced stems at a mean follow-up of 5 years. Selection of these femoral heads was based on several factors, including the perceived risk of dislocation, the outer diameter size of the acetabular component, and liner availability. Measurements of linear wear were performed by experienced surgeons with Dorr method and analyzed using the first-to-last method. Standard radiographs were used to detect periprosthetic osteolysis. Clinical records were used to determine all demographic data (age, height, weight, gender, months of follow-up, etc.). RESULTS: For the entire cohort, the median linear wear rate was 0.0438 mm per year at 5 years and there was no any revision due to loosening, no liner fracture, and no patient with symptomatic corrosion. The head size was selected intraoperatively based on the size of the acetabular component and presumed risk of dislocation. There was no hip with pelvic or femoral osteolysis. The median linear wear rate was 0.0461 mm (±0.0183) and 0.0409mm (±0.0118), respectively, at head diameters of 40 and 44 mm. We found no association between femoral head size and the linear wear rate. This sentence can be excluded from here CONCLUSIONS: This acetabular component and HXLPEs with large ceramic heads had low rates of linear wear. Large ceramic femoral heads did not lead to liner fracture, loosening, or symptomatic trunnion corrosion in this patient population. However, we recommend longer clinical follow-up studies and caution in the routine use of larger ceramic femoral heads in other, younger patient populations. KEY WORDS: Ceramic femoral heads, Highly cross-linked polyethylene, Large heads, Total hip arthroplasty.

The effect of astaxanthine on ischemia-reperfusion injury in a rat model.

BACKGROUND: We aimed to compare biochemical and histopathological findings of astaxanthin's potential effects on oxidative stress in ischemia/reperfusion damage (I/R). METHODS: Thirty-two rats were randomly divided into four groups: control group; I/R group; I/R + treatment group; drug group. Astaxanthin was orally administered to groups C and D for 14 days. In groups B and C, the femoral artery was clamped for 2 h to form ischemia. The clamp was opened, and reperfusion was performed for 1 h. In all groups, 4 ml of blood sample through intracardiac puncture and gastrocnemius muscle tissue samples were collected. Serum and tissue samples were analyzed by measuring malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant capacity (TAC), and total oxidative level (TOL). Necrosis, inflammation, and caspase-3 in muscle tissue collected for histopathological examination were evaluated. RESULTS: Tissue MDA, SOD and TOL values significantly differed between groups. Serum MDA, SOD, TOL and TAC values significantly differed between groups. On necrosis examination, there was a significant difference between groups B and C. Although signs of inflammation significantly differed between groups, there was no significant difference between groups A and C and groups A and D. Although there was a significant difference in caspase-3 results between groups, there was no significant difference between groups A and C. CONCLUSIONS: The use of astaxanthin before and after surgery showed preventive or therapeutic effects against I/R damage.

Severe cases of osteogenesis imperfecta type VIII due to a homozygous mutation in P3H1 (LEPRE1) and review of the literature.

BACKGROUND: Osteogenesis imperfecta (OI) is a genetic disorder that causes skeletal fragility, multiple fractures and several extraskeletal disorders. Most cases of OI are caused by mutations in COL1A1/A2. Osteogenesis imperfecta type VIII typically causes a severe and fatal phenotype that presents at birth with severe osteopenia, congenital fractures and other clinical manifestations. OBJECTIVES: We describe the cases of an 11-year-old female and a 9-year-old male with homozygous truncating mutations in P3H1. Both cases were born with intrauterine fractures and suffered multiple fractures shortly after birth, requiring multiple operations to correct both fractures and severe scoliosis. The patients have been treated with pamidronate since the age of 2. MATERIAL AND METHODS: Whole exome sequencing (WES) was performed by Gene by Gene using Twist Bioscience technology. Initially, ~36.5 Mb of consensus coding sequences (targeting >98% of RefSeq and Gencode v. 28 regions obtained from the human genome) was replicated from fragmented genomic DNA using the Twist Human Core Exome Plus kit. The subsequent library was sequenced on the Illumina Novaseq Next Generation Sequencing platform to achieve at least ×20 reading depth for >98% of the targeted bases. Variant annotations and filtering was performed using Ingenuity Variant Analysis software. RESULTS: We identified a homozygous mutation in the 3rd exon of P3H1 (c.628C>T/p.Arg210 Ter). Our cases broaden the phenotypic spectrum of OI type VIII as, to the best of our knowledge, these are the first postnatal cases with P3H1 (c.628C>T/p.Arg210 Ter) mutations published in the literature. CONCLUSIONS: We present the first recorded postnatal cases from unrelated families of OI type VIII, broadening our understanding of the severe, but nonfatal spectrum of clinical phenotype of this recessive form of OI.

Effects of Cyanoacrylate in Rabbits with Induced Achilles Tendon Rupture.

BACKGROUND In this study, we aimed to investigate the effects of N-butyl-2-cyanoacrylate (cyanoacrylate) on the biomechanical and histopathological aspects of tendon healing in a rabbit model of Achilles tendon injury. MATERIAL AND METHODS In total, 36 rabbits were randomized to experimental (cyanoacrylate) and control groups (n=36 tendons in each group). A simple suture was used in the control group and a simple suture plus cyanoacrylate was used in the experimental group. Nine rabbits from each group were euthanized at week 4 and week 6 after surgery for histopathological and biomechanical testing. RESULTS Granulation tissue formation was significantly greater in the experimental group in week 4 and week 6 than in the control group. Foreign body giant cell formation was significantly higher in the experimental group in week 4 and week 6. The maximum rupture force was significantly higher in the experimental group in week 4 and week 6 than in the control group. Elasticity and stiffness were comparable between groups in week 4; however, stiffness, but not elasticity, was significantly higher in the experimental group in week 6. CONCLUSIONS In the short term, cyanoacrylate enhanced tendon endurance in both a histopathological and biomechanical manner. We conclude that the early initiation of rehabilitation in patients may be safe in cases of cyanoacrylate use for surgical repair of tendon injury.

Treatment of Psoas abscess related coxarthrosis due to salmonella infection in a patient with chronic renal failure. A case report.

INTRODUCTION: The most common microorganisms isolated from septic arthritis are staphylococcus aureus and streptoccocci. Septic arthritis due to Salmonella spp. is extremely rare. PRESENTATION OF CASE: A 55-year-old man, chronic renal failure, is admitted hip arthtritis with newly arised symptoms. The findings were not compatible with primary arthritis. The laboratory findings which include white blood cell count, erythrocyte sedimentation rate (esr) and c-reactive protein (crp) were elevated. In magnetic resonance (mr) imaging there were psoas abscess and septic arthritis of the hip. They were treated by drainage. The culture was confirmed as Salmonella spp. Antibiotic treatment were done. DISCUSSION: Uremia in patients with chronic renal failure is associated with a state of immune dysfunction. In our case, uremia may cause immunosuppressive conditions and hematogenous dissemination of salmonella. CONCLUSION: Salmonella infection in a patient with chronic renal failure may be occured. It must be kept in mind that early diagnosis, administration of appropriate systemic antibiotics and surgical intervention play a pivotal role in successful management. KEY WORDS: Arthritis, Failure, Psoas, Salmonella Renal Abscess.

Does methylene blue reduce adhesion during the healing process after tendon repair?

OBJECTIVES: This study aims to biomechanically and histopathologically investigate the effects of methylene blue (MB) on preventing postoperative adhesion in chickens undergoing full- thickness flexor tendon incision. MATERIALS AND METHODS: This study was performed between June 2017 and June 2018 on Hubbard JA 57 type chickens (age, 6 months; weight, 2.2±0.3 kg). Sixty-four tendons were studied in 32 chickens, including 16 in the control group and 16 in the experimental group. The second and third finger flexor digitorum profundus tendons of the left foot of each chicken were repaired primarily after a full-thickness incision approximately 1 cm proximal to the distal adhesion area. In the control (n=32) and experimental groups (n=32), 0.25 mL of normal saline and 0.25 mL of 1% MB solutions were applied locally to the surgical site, respectively. The operated limb was immobilized using a circular cast. 16 chickens were randomly selected in each group and examined at the fourth week, and the remaining 16 chickens were examined at the sixth week. Thirty-two of these tendons were evaluated using the Tang histopathological adhesion classification system, and the other 32 were evaluated with a biomechanical pull system. RESULTS: Adhesion was found to be less in the experimental group compared to the control group at the end of the fourth and sixth weeks both histopathologically and biomechanically. Furthermore, adhesion was significantly less in the experimental group at the end of the sixth week compared to the fourth week both histopathologically and biomechanically. CONCLUSION: Histopathological and biomechanical results show that MB, which has anti-inflammatory, antiseptic, antimicrobial and antioxidant effects, reduces adhesion during the healing process after tendon repair. We think that local MB application, particularly in surgeries performed after this type of injury, will be beneficial on early rehabilitation and functional results.